There are over 1.8 billion young people in the world today, 90 per cent of whom live in developing countries; around five million are living with HIV. In new figures released by WHO this week, the failure to adequately support 10 to 19 year olds* has resulted in a 50% increase in reported AIDS-related deaths among this age group between 2005 and 2012, bucking the trends in the latest UNAIDS data that has seen deaths among the general population fall by 30%.
Lack of knowledge, gender inequalities, cultural norms, stigma and discrimination, limited youth-tailored interventions and service providers’ attitudes are just some of the factors that prevent young people from accessing sexual and reproductive health services.
According to Helen Parry, a senior advisor on sexual and reproductive health with the Alliance: “Many young people do not have the information or means to protect themselves from HIV. Denying them knowledge and access to services is jeopardising their future. If we fail to reach young people who are most affected by HIV, including those actually living with the virus and those who are particularly vulnerable and marginalized, we will never get new infections under control.
“The current generation of young people is the first never to have known a world without AIDS,” she said. “We’re thirty years into the epidemic now and young people living with HIV continue to face discrimination and exclusion on a daily basis. Protecting, respecting and promoting their human rights, including their sexual and reproductive rights, is critical.”
In another world
That’s why, this World AIDS Day, we have released a short film – That Time – to highlight the impact of lack of access to HIV information and services on young people like Momina from Ethiopia.
Life for Momina and her family could have turned out so very differently if she had known how to protect herself against HIV, if she had had proper antenatal care when she was pregnant with her second son, if she had not felt compelled to run away from home for fear of early marriage. Offering a full range of contraceptive methods, comprehensive information and HIV prevention tools empowers young people to make healthy decisions and access dual protection, enabling them to prevent HIV, unintended pregnancies and sexually transmitted infections.
New awareness, new challenges
It feels as if the world is
waking up to the specific needs of young people living with and affected
by HIV. Next month the UNAIDS Programme Coordinating Board will have a
special thematic session on adolescents living with and most affected
by HIV. And the first ever WHO guidelines released this month on HIV
support and care for adolescents call for more tailored approaches to
testing and counselling and better, more immediate, access to treatment
if young people test positive. They also reference key populations
including young people who inject drugs and young transgender people.
Kate Iorpenda, our senior advisor on children said: “What will be crucial is marrying the guidelines with the reality on the ground, so for example how best to reach a young gay man with HIV prevention, treatment and support services in a country where same sex relations may still be criminalised. Or how best to care for a child who is being sexually exploited or married at an early age. As always the devil will be in the detail and we look forward to countries better tailoring their HIV services for adolescents as a result of the guidelines.”
For many civil society and state HIV programmers, there are still big unanswered questions when it comes to working with young people. Targeting young key populations requires the ability to differentiate interventions across ages, work within varied legal systems with different restrictions on providing services to young people and the need for more specialised experience of reaching young people around issues such as drug use, sexual behaviour, gender identity and sexuality. This work can be extremely contentious and can present ethical and legal challenges for programmers.
“For the Alliance we are clear about the need for rights based practice and about participation — ‘nothing about us without us’ — and the need to address harmful laws and removal of legal penalties. Moving forward, we need to explore how within our programmes we can support the rights of young people while recognising and mitigating against the level of personal and organisational risk this currently entails” said Iorpenda.
Imagine a world without AIDS – we must
So, as the world moves towards agreeing a post-2015 development agenda, a commitment to universal health care for all must be at its centre, along with targets aimed at eliminating AIDS-related deaths and significantly reducing new HIV infections. This is essential for the next generation of young people to live, love and learn in a world without AIDS.
- Read about the support that Momina is now receiving from OSSA, our Linking Organisation in Ethiopia in Momina's story here.
- Read more about the ambitious three-year country programme – Link Up – which aims to improve the sexual and reproductive health and rights of young people in Ethiopia, Bangladesh, Burundi, Myanmar and Uganda.
- Read more about the Alliance’s work on linking HIV and sexual and reproductive health
- Read this blog by Alliance Policy Manager, Marielle Hart, on Universal Health Care: leaving no-one behind
* The UN definition of adolescents is 10-19 years.
The current generation of young people is the first never to have known a world without AIDS.